Department of Surgery, Northwestern University, Chicago, Illinois.
Department of Surgery, University of Illinois at Chicago, Chicago, Illinois.
J Surg Educ. 2017 Nov-Dec;74(6):946-951. doi: 10.1016/j.jsurg.2017.05.003. Epub 2017 May 18.
Mock oral examinations are often used to prepare residents for the American Board of Surgery certifying examination. Another potential use of these examinations is to identify programmatic weaknesses. Results from a multi-institutional mock oral examination were evaluated to determine if specific areas of weakness within each of the participating programs could be identified to facilitate program development.
A mock oral examination was administered annually consisting of 3 examination rooms per resident with 3 cases in each room. Case categories included core general surgery and subspecialties and cases were changed yearly. Each case included facets of patient management from history and physical examination, and differential diagnosis to postoperative care and professional behaviors.
General Surgery programs at 3 academic medical centers-Northwestern University, Rush University, and University of Illinois at Chicago.
A total of 259 resident examinations of fourth- and fifth-year general surgery residents over a 7-year period.
A total of 2331 individual resident cases were evaluated with an overall case pass rate of 50.2% across all 3 programs. The weakest case category for each program was different (A = vascular 40.0% pass, B = trauma 41.4% pass, and C = breast 30.0% pass). All programs scored above their mean in gastrointestinal and abdominal surgery and below their mean in vascular surgery. Within vascular surgery, the weakest facet of patient management also differed between programs (A = select tests 44.3% pass, B = complications 57.0% pass, and C = history and physical 55.4% pass).
A standardized mock oral examination is able to identify topic areas of relative strength and weakness that differ between programs. These results can be used to define focused areas for improvement within training programs, guide rotation schedules, and improve didactic curricula.
模拟口头考试通常用于为住院医师准备美国外科委员会认证考试。这些考试的另一个潜在用途是确定项目的薄弱环节。评估了一项多机构模拟口头考试的结果，以确定是否可以确定每个参与项目中的特定薄弱领域，以促进项目发展。
每年进行一次模拟口头考试，每个住院医师有 3 个考试室，每个房间有 3 个病例。病例类别包括核心普通外科和亚专业，病例每年都有变化。每个病例都包括从病史和体格检查、鉴别诊断到术后护理和专业行为的患者管理方面。
西北大学、拉什大学和伊利诺伊大学芝加哥分校的 3 个学术医疗中心的普通外科项目。
在 7 年期间，共有 259 名四年级和五年级普通外科住院医师接受了考试。
在所有 3 个项目中，共有 2331 名个别住院医师的病例接受了评估，总体病例通过率为 50.2%。每个项目中通过率最低的病例类别都不同（A =血管 40.0%通过，B =创伤 41.4%通过，C =乳房 30.0%通过）。所有项目在胃肠和腹部手术方面的得分均高于平均值，而在血管手术方面的得分均低于平均值。在血管外科中，患者管理的最薄弱方面在不同项目之间也有所不同（A =选择测试 44.3%通过，B =并发症 57.0%通过，C =病史和体格 55.4%通过）。
标准化模拟口头考试能够识别出不同项目之间相对强弱的主题领域。这些结果可用于确定培训项目内需要改进的重点领域，指导轮转计划，并改进教学课程。
